-- Robert Preidt
WEDNESDAY, Aug. 6, 2014 (HealthDay News) Another study confirms
that "time is brain" when treating stroke patients with a powerful
clot-busting drug, tPA.
Prompt treatment with tissue plasminogen activator (tPA, also
known as alteplase) "is a very effective means of limiting the
degree of disability in stroke patients," study co-author Dr.
Jonathan Emberson, of University of Oxford in the U.K., said in a
news release from the journal
The study, published in the journal on Aug. 5, also reinforces
the idea that the quicker that patients can get tPA, the
One U.S. expert agreed. "The analysis reiterates the importance
of patients going to the ER immediately at the time of developing
acute neurological symptoms that could be due to a stroke," said
Dr. Rafael Alexander Ortiz, director of interventional
neuroradiology and stroke at Lenox Hill Hospital in New York
Clot-busting drugs are used to treat people who have suffered an
ischemic stroke, which occurs when a clot blocks blood flow to the
In the study, Emberson's team looked at data from more than
6,700 stroke patients who took part in nine clinical trials
The likelihood of a good outcome -- defined as no significant
disability three to six months after stroke -- were 75 percent
higher for patients who received the drug within three hours of
initial stroke symptoms, compared with patients didn't get tPA.
While that three-hour window is ideal, even patients who got tPA
a bit later received some benefit. For example, the chances of a
good outcome were still 26 percent higher among patients who
received the clot-buster within 4.5 hours of the attack, and 15
percent higher for those who received the drug more than four to
five hours after initial stroke symptoms, the group found
The benefits of quick treatment with tPA were seen in all
patient groups, including those older than 80 and those with severe
strokes, the authors add.
There was a slight added risk with the drug, however: the
researchers also found that tPA increased the risk of dying from
brain bleeding by about 2 percent within the first few days after
One U.S. stroke expert called the new review "powerful."
"The information is very significant because it helps support our concept of 'time is brain' by showing that faster treatment times do result in better outcomes for patients," said Dr. Keith Siller, director of the Stroke Consultative Service at North Shore-LIJ's Cushing Neuroscience Unit in Manhasset, N.Y.
He said that the finding that tPA helped even elderly patients
was key, because "there has been a negative bias about offering IV
tPA because of concerns about decreased clinical benefit and
increased hemorrhage in this subset of patients."
Lancetnews release, study co-author Kennedy Lees, a
professor of cerebrovascular medicine at the University of Glasgow,
in Scotland, said that "what this shows is that we are up against
the clock when treating ischemic stroke. Every minute counts.
People need to be identified quickly and systems need to be in
place to get them scanned, diagnosed accurately and then treated
within minutes to hours."
The American Heart Association/American Stroke Association has
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